Pharmacists aren't profit-seekers, they fill a vital gap

In Joanna Moorhead's article about the increasing provision of over-the-counter medicines from pharmacies, Professor Steve Field, chairman of the Royal College of GPs, is reported as saying that "a pharmacist makes their profit selling over-the-counter medicines whereas your GP has no pecuniary benefit in giving you medicine" (Shelf medication, 2 June). This is misleading, and typical of an article that characterises pharmacists as profit-seekers, Whitehall as miserly and GPs' organisations as bastions of moral rectitude. Your report gave far more space to GPs' organisations than to pharmacy, and the patient's voice was absent.

Community pharmacies derive most of their income, as do GP practices, from professional fees paid by the NHS for their services; sales of over-the-counter medicines form a minority of their income. And GP practices do get "pecuniary benefit" from prescribing; they are financially rewarded by the Department of Health for prescribing certain medicines in groups of patients.

Your report says "if concerns about using a drug ... emerge once it is widely available, it can be difficult to pass those on to consumers". It isn't difficult: the medicines are sold through pharmacies, and so the method of control is the pharmacist. As someone who teaches about the practice of pharmacy, I would say it is arguably the best regulated of health professions and has often responded rapidly to health concerns by voluntarily controlling access to medicines or ensuring appropriate advice goes with supply.

Field says that "many of the things available over the counter don't work". But the concept of "what works" is contestable. A placebo can improve the health of 25% of patients, yet the most effective licensed medicines that your GP can prescribe will only cause the desired health outcome in 50% of patients. Patients buy what works for them - if they don't think it works, they don't buy it again.

I remember the time when if a woman started with thrush on a Friday afternoon, her options for getting treatment were either queuing for hours in a hospital A&E over the weekend, or taking time off work on Monday morning to see her GP. Now she can buy an effective treatment immediately. The consumer has access to a wide range of effective treatments from a choice of pharmacies open at convenient times, with free, rapid access to an expert on tap: ask for the pharmacist and the average time you have to wait is 90 seconds. Surely that is worth celebrating.

Healthcare is changing. Hospital work is being passed to GPs, and the use of medicines is ever growing, yet there are not enough doctors in the UK. The current system is unsustainable and puts patients at risk - already 5% of hospital admissions are a result of avoidable harm from medicines. A sustainable partnership between GPs and pharmacists is the only rational way forward - one that truly serves patients, giving them access and choice in a safe way, while respecting the strengths, constraints and income streams of both professions.

• Nick Barber is professor of the practice of pharmacy at the School of Pharmacy, University of London, and a member of the council of the Royal Pharmaceutical Society of Great Britain